BC Family Doctors recently asked members to share their experiences with fee-for-service billing. You shared insightful and detailed feedback that gives us a clear picture of both the strengths of fee-for-service and the urgent need for reform.
What’s Working Well
- Many doctors value the autonomy and efficiency that fee-for-service provides, particularly for high-volume and procedure-based work.
- Facility-based codes, such as call-out surcharges, hospital visits, and care conferencing, are seen as reliable tools for ensuring appropriate compensation.
- This payment model remains essential for physicians whose work falls outside the LFP Payment Model, including surgical assists and emergency care.
What’s Not Working
- Family physicians voiced strong concerns about outdated office visit and counselling codes, noting they no longer reflect the realities of patient care – especially for mental health.
- Physicians also emphasized the significant amount of unpaid and underpaid indirect care they provide, from reviewing test results to completing forms.
- Confusing rules, rejected claims, and audit anxiety add to the burden, creating barriers to effective use of the system.
Priorities for Reform
Physicians called for modernized compensation that better reflects complexity, mental health, and indirect work, alongside new codes for teaching, after-hours care, and team-based practice. Creating a simpler, more equitable system – with fewer codes, fairer payments, and transparent adjudication – was a consistent theme.
Complexity and mental health need time; under fee-for-service we are not paid for time. This is a fundamental problem which needs addressing.
We thank all members who took the time to provide feedback and share their experiences. Your input will guide our ongoing work to improve fee-for-service as an essential part of a healthcare system that values family doctors, respects patients, and strengthens primary care in BC.